The Use of Opioids in the Management of Chronic Pain
Authors: Steven P. Cohen, Timothy C. Dawson, Paul F. Pasquina
Journal: Annals of Internal Medicine (2023)

LettersSeptember 2023The Use of Opioids in the Management of Chronic PainSteven P. Cohen, MD, Timothy C. Dawson, MD, Paul F. Pasquina, MDSteven P. Cohen, MDJohns Hopkins School of Medicine, Baltimore, Maryland, and Walter Reed National Military Medical Center, Bethesda, MarylandSearch for more papers by this author, Timothy C. Dawson, MDVA Puget Sound Health Care System, Seattle, WashingtonSearch for more papers by this author, Paul F. Pasquina, MDWalter Reed National Military Medical Center and Uniformed Services University of the Health Sciences, Bethesda, MarylandSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L23-0224 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR: We read with interest Sandbrink and colleagues' synopsis of the U.S. Department of Veterans Affairs (VA) and U.S. Department of Defense (DoD) guideline on opioid use (1). The guideline is stricter than nearly all other national guidelines, including the updated guidelines from the Centers for Disease Control and Prevention (2, 3). However, the VA/DoD Guideline Development Group cited evidence to support their recommendations and acknowledged that guidelines are not synonymous with standard of care and should not supersede clinician judgment. This is important given the diversity of the military and veteran populations.Still, several issues warrant careful ...References1. Sandbrink F, Murphy JL, Johansson M, et al; VA/DoD Guideline Development Group. The use of opioids in the management of chronic pain: synopsis of the 2022 updated U.S. Department of Veterans Affairs and U.S. Department of Defense clinical practice guideline. Ann Intern Med. 2023;176:388-397. [PMID: 36780654] doi:10.7326/M22-2917 LinkGoogle Scholar2. Dowell D, Ragan KR, Jones CM, et al. CDC clinical practice guideline for prescribing opioids for pain—United States, 2022. MMWR Recomm Rep. 2022;71:1-95. [PMID: 36327391] doi:10.15585/mmwr.rr7103a1 CrossrefMedlineGoogle Scholar3. Busse JW, Craigie S, Juurlink DN, et al. Guideline for opioid therapy and chronic noncancer pain. CMAJ. 2017;189:E659-E666. [PMID: 28483845] doi:10.1503/cmaj.170363 CrossrefMedlineGoogle Scholar4. Cohen SP, Gallagher RM, Davis SA, et al. Spine-area pain in military personnel: a review of epidemiology, etiology, diagnosis, and treatment. Spine J. 2012;12:833-42. [PMID: 22100208] doi:10.1016/j.spinee.2011.10.010 CrossrefMedlineGoogle Scholar5. Moore BA, Brock MS, Brager A, et al. Posttraumatic stress disorder, traumatic brain injury, sleep, and performance in military personnel. Sleep Med Clin. 2020;15:87-100. [PMID: 32005353] doi:10.1016/j.jsmc.2019.11.004 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Steven P. Cohen, MD; Timothy C. Dawson, MD; Paul F. Pasquina, MDAffiliations: Johns Hopkins School of Medicine, Baltimore, Maryland, and Walter Reed National Military Medical Center, Bethesda, MarylandVA Puget Sound Health Care System, Seattle, WashingtonWalter Reed National Military Medical Center and Uniformed Services University of the Health Sciences, Bethesda, MarylandDisclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L23-0224. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoThe Use of Opioids in the Management of Chronic Pain: Synopsis of the 2022 Updated U.S. Department of Veterans Affairs and U.S. Department of Defense Clinical Practice Guideline Friedhelm Sandbrink , Jennifer L. Murphy , Melanie Johansson , Juli L. Olson , Ellen Edens , Jamie Clinton-Lont , James Sall , and Christopher Spevak , for the VA/DoD Guideline Development GroupThe Use of Opioids in the Management of Chronic Pain James L. Sall , Friedhelm Sandbrink , Jennifer L. Murphy , Christopher Spevak , Ellen Edens Metrics Current IssueSeptember 2023Volume 176, Issue 9KeywordsOpioidsPainPain managementTreatment guidelines ePublished: 19 September 2023 Issue Published: September 2023 Copyright & PermissionsCopyright © 2023 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...